Factors predicting pathological upgrading after prostatectomy in patients with Gleason grade group 1 prostate cancer based on opinion‑matched biopsy specimens

Maruyama, Yuki; Sadahira, Takuya; Araki, Motoo; Mitsui, Yosuke; Wada, Koichiro; Rodrigo, Acosta Gonzalez Herik; Munetomo, Kazuaki; Kobayashi, Yasuyuki; Watanabe, Masami; Yanai, Hiroyuki; Watanabe, Tetsu; Nasu, Yasutomo

doi:10.3892/mco.2020.1996

Cited by 8 publications

(10 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A discordant GG between needle biopsy and final pathology is associated with interobserver variability among different pathologists, borderline grades, and more significantly sampling errors 26 . In support of these arguments, Maruyama et al reported that GG concordance improved by 6.2% after second-opinion pathology 27 .…”

Section: Discussionmentioning

confidence: 88%

Machine learning prediction of Gleason grade group upgrade between in-bore biopsy and radical prostatectomy pathology

Ozbozduman,

Loc,

Durmaz

et al. 2024

Sci Rep

View full text Add to dashboard Cite

This study aimed to enhance the accuracy of Gleason grade group (GG) upgrade prediction in prostate cancer (PCa) patients who underwent MRI-guided in-bore biopsy (MRGB) and radical prostatectomy (RP) through a combined analysis of prebiopsy and MRGB clinical data. A retrospective analysis of 95 patients with prostate cancer diagnosed by MRGB was conducted where all patients had undergone RP. Among the patients, 64.2% had consistent GG results between in-bore biopsies and RP, whereas 28.4% had upgraded and 7.4% had downgraded results. GG1 biopsy results, lower biopsy core count, and fewer positive cores were correlated with upgrades in the entire patient group. In patients with $$\hbox {GG}>1$$ GG > 1 , larger tumor sizes and fewer biopsy cores were associated with upgrades. By integrating MRGB data with prebiopsy clinical data, machine learning (ML) models achieved 85.6% accuracy in predicting upgrades, surpassing the 64.2% baseline from MRGB alone. ML analysis also highlighted the value of the minimum apparent diffusion coefficient ($$\hbox {ADC}_{\text{min}}$$ ADC min ) for $$\hbox {GG}>1$$ GG > 1 patients. Incorporation of MRGB results with tumor size, $$\hbox {ADC}_{\text{min}}$$ ADC min value, number of biopsy cores, positive core count, and Gleason grade can be useful to predict GG upgrade at final pathology and guide patient selection for active surveillance.

show abstract

Section: Discussionmentioning

confidence: 88%

Machine learning prediction of Gleason grade group upgrade between in-bore biopsy and radical prostatectomy pathology

Ozbozduman,

Loc,

Durmaz

et al. 2024

Sci Rep

View full text Add to dashboard Cite

show abstract

“…[ 19 ] Numerous publications showed that mandatory second opinion pathology review by specialized urological pathologists leads to alteration of the management strategy and improved care in some cases. [ 3 7 8 11 20 ] The accuracy of the GS in NCB specimens depends on the experience in uropathology and workload of the reviewing pathologist. [ 3 ] A major discrepancy in the GS assigned by general versus specialized pathologists occurs in 15%–41% of NCB specimens.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, increasing the number of biopsy cores improves both sampling and accuracy. [ 11 ] Conversely, a small number of biopsy cores with a shorter length might lead to the overestimation of the GGG in NCB specimens. Another way to reduce sampling error is to improve tumor visualization and targeting during the biopsy.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A second opinion pathology review improves the diagnostic concordance between prostate cancer biopsy and radical prostatectomy specimens

Maehara¹,

Sadahira²,

Maruyama³

et al. 2021

Urol Ann

Self Cite

View full text Add to dashboard Cite

Objectives: The Gleason scoring system is an essential tool for determining the treatment strategy in prostate cancer (PCa). However, the Gleason grade group (GGG) often differs between needle-core biopsy (NCB) and radical prostatectomy (RP) specimens. We investigated the diagnostic value of a second opinion pathology review using NCB specimens in PCa. Materials and Methods: We retrospectively evaluated 882 patients who underwent robot-assisted RP from January 2012 to September 2019. Of these, patients whose original biopsy specimens were obtained from another hospital and reviewed by the urological pathology expert at our institution were included in the study. Patients who received neoadjuvant hormonal therapy were excluded from the study. Weighted kappa (k) coefficients were used to evaluate the diagnostic accuracy of each review. Results: A total of 497 patients were included in this study. Substantial agreement (weighted k = 0.783) in the GGG between initial- and second-opinion diagnoses based on NCB specimens was observed in 310 cases (62.4%). Although diagnoses based on a single opinion showed moderate agreement with the GGG of RP specimens (initial: 35.2%, weighted k = 0.522; second opinion; 38.8%, weighted k = 0.560), matching initial and second opinion diagnoses improved the concordance (42.9%, 133/310 cases) to substantial agreement (weighted k = 0.626). Conclusions: A second opinion of PCa pathology helps to improve the diagnostic accuracy of NCB specimens. However, over half of diagnoses that matched between the initial and second opinions differed from the diagnosis of RP specimens.

show abstract

“…At smaller facilities, the diagnosis is not always made by experienced pathologists. Although diagnosis by experienced urological pathologists provides a more accurate GG assessment than inexperienced pathologists [14][15][16], only a few cases are available to verify whether reassessments are truly beneficial for the patient [17]. As our institution is a high-volume institution with experienced urological pathologists, we often reassess specimens from other institutes.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic significance of reassessment of prostate biopsy specimens by experienced urological pathologists at a high-volume institution

et al. 2022

View full text Add to dashboard Cite

In prostate cancer, accurate diagnosis and grade group (GG) decision based on biopsy findings are essential for determining treatment strategies. Diagnosis by experienced urological pathologists is recommended; however, their contribution to patient benefits remains unknown. Therefore, we analyzed clinicopathological information to determine the significance of reassessment by experienced urological pathologists at a high-volume institution to identify factors involved in the agreement or disagreement of biopsy and surgical GGs. In total, 1325 prostate adenocarcinomas were analyzed, and the GG was changed in 452/1325 (34.1%) cases (359 cases were upgraded, and 93 cases were downgraded). We compared the highest GG based on biopsy specimens, with the final GG based on surgical specimens of 210 cases. The agreement rate between the surgical GG performed and assessed in our institute and the highest biopsy GG assessed by an outside pathologist was 34.8% (73/210); the agreement rate increased significantly to 50% (105/210) when biopsy specimens were reevaluated in our institute (chi-square test, P < 0.01). Multivariate logistic regression analysis showed that only the length of the lesion in the positive core with the highest GG in the biopsy was a significant factor for determining the agreement between biopsy GG and surgical GG, with an odds ratio of 1.136 (95% confidence interval: 1.057–1.221; P < 0.01). Thus, reassessment by experienced urological pathologists at high-volume institutions improved the agreement rate. However, it should be noted there is a high probability of discordance between a small number of lesions or short lesions and surgical GG.

show abstract

Factors predicting pathological upgrading after prostatectomy in patients with Gleason grade group 1 prostate cancer based on opinion‑matched biopsy specimens

Cited by 8 publications

References 33 publications

Machine learning prediction of Gleason grade group upgrade between in-bore biopsy and radical prostatectomy pathology

Machine learning prediction of Gleason grade group upgrade between in-bore biopsy and radical prostatectomy pathology

A second opinion pathology review improves the diagnostic concordance between prostate cancer biopsy and radical prostatectomy specimens

Diagnostic significance of reassessment of prostate biopsy specimens by experienced urological pathologists at a high-volume institution

Contact Info

Product

Resources

About